DIGITAL
MEDICAL OFFICE OF THE FUTURE
DIGITAL
MEDICAL OFFICE OF THE FUTURE
7.01 Physicians and Physician Organizations: Making the Purchasing Decision
Developing Your Requirements and Making Your Selection
MARK ANDERSON, CPHIMS, FHIMSS
Nationally recognized expert in ambulatory EMRs
More than 30 years of professional experience inhealthcare management and information technology
Integrated Delivery Networks (IDNs) Hospitals
Payer organizations
Physician practices / organizations
National speaker >over 350 sessions since 2000ELECTRONIC HEALTH RECORDS
Institute of Medicine Vision of EHR
-To document all episodes of healthcare where ever they take place.
To provide immediate access to data.
To process data in a variety of ways to support better decision making for patient care and clinical and health services research.
To increase efficiency of healthcare organizations and decrease the costs of services.
To ensure confidentiality of data.
Transitioning from Paper to
Digital Electronic Medical Records
EMR ISSUES
Too many vendors selling EMRs
Not many financially viable companies
How do you decide what functions are important?
How do you decide which vendors to look at?
How do the vendors rate in functionality?0% 5% 10% 15% 20% 25% 30% 35% 40%
Messaging DIM Charting EMR EHR
2000 2003 2005
INTRODUCTION TO EMRs
DIGITAL MEDICAL
OFFICE FUNCTIONALITY
X PHR X Health Maint. X X Chief Complaint X X National Alerts X X Standards/CCR X X X E & M CodingX X X X E-Prescribe X X X X X Paper Doc X X X X X X Transcription X X X X X X Labs X X X X X X X Scheduling X Billing EHR EMR EMR Lite Charting DIM Secured Message PMS Function
CALCULATING YOUR OWN ROI
Coding improvements
Payment improvements including dropping the bill faster and avoiding “lost” charges
Reduction in malpractice
Reduction in transcription costs
Reduction in paper, forms, and supply costs Recover storage space
Reallocation and retention of staff – NOT staff reduction Physicians save 4 hours per week – NOT patient time Nurses save an average 6 hours per week
Staff save an average of 6 hours per week per physician
Being paid for enhancing patient care is becoming the norm; clinical benefit is provable now
Documented savings of $12.50 to $20.00 per patient visit
RESULTS
74% of discarded EMRs were because thesoftware did not meet the actual needs of the physicians.
Spending too much for the software.
80% of the vendors implementing the software donot help the practice determine “how” to use the product to improve operations.
The wrong EMR decision could cost the averageWHAT NOT TO DO
Research the products by yourself.
Rely on your friends or associates.
Rely on hearsay.
Rely on vendor advertising claims.
Rely on vendor claims of functionality and companyviability.
Try to implement the product by yourself.
Assume the software installation includesEMR Functional Evaluations
• AC Group conducted extensive evaluation of the EMR marketplace
9 4th report
9 Completed in October 2004
9 Included over 5,455 functional questions
9 27 categories of functionality
9 26 subcategories of charting functionality
9 4 delivery methods (desktop, remote, wireless, and PDA)
5 - Star EHR Vendor Applications
Vendors Meeting a Minimum of 80% of Required Functionality
70% 75% 80% 85% 90% 95% 100% Ra ti n g Overall Score NextGen EPIC Allscripts Cerner ** Bond Medical eClinicalworks SynaMed Med Com Sys PMSI
JMJ
MedInformatix iGreat
Imedica
5-Star EMR Vendor Applications
Vendors Meeting a Minimum of 80% of Required Functionality
75% 77% 79% 81% 83% 85% 87% 89%
Rat
in
g
Overall Score
Bond Medical eClinicalworks SynaMed Med Com Sys PMSI
JMJ
MedInformatix iGreat
5-Star Charting Vendor Applications
Vendors Meeting a Minimum of 60% of Required Functionality
60% 65% 70% 75% 80% Ra ti n g Overall Score Cliniflow Vista Care GE Medical Misys Greenway Vitalworks MerianEMR Praxis Orion A4 Healthcare e-MDS Chartcare DR Notes MDAnywhere McKesson
5-Star EMR Lite Applications
Vendors Meeting a Minimum of 80% of Required Functionality
40% 50% 60% 70% 80%
Rat
in
g
Overall Score
iGreat
AIC Solutions
Med Net Systems Axolotol
HealthVision
Top EMR/EHR Vendor Applications
Large Practices > 100 Physicians50% 60% 70% 80% 90% 100%
Rat
in
g
Overall Score
NextGen EPIC Allscripts Cerner ** eClinicalworks iGreat
Imedica GE Medical Misys
Top EMR/EHR Vendor Applications
Mid –Sized Practices from 10 to 99 Physicians70% 75% 80% 85% 90% 95% 100% Rat in g Overall Score NextGen Allscripts Cerner ** Bond Medical eClinicalworks SynaMed Med Com Sys PMSI MedInformatix iGreat Imedica GE Medical Misys Greenway Vitalworks
Top EMR/EHR Vendor Applications
Small Practices from 1 to 9
70% 75% 80% 85% 90%
Ra
ti
n
g
Desktop
Bond Medical eClinicalworks SynaMed PMSI JMJ
MedInformatix Cliniflow
(Monarch) Vista Care GE Medical Misys
Greenway
Other Factors
• Company Viability
Years in the EMR Market
EMR Revenues and % of Revenues Cash flow
Staff size
• Experience with large MSO/IPAs
• Interoperability
• 5-Rights
Access Anywhere, Anytime, on Any
Device, from Any Location, by Anyone that is a clinician of record
Top EMR/EHR Vendor Applications
Based on Functionality, Company Viability and end-user satisfaction
15 20 25 30 35
Ra
ti
n
g
NextGen Allscripts EPIC
GE Medical Misys
PMSI McKesson A4 Healthcare eClinicalworks iGreat
Imedica
MedInformatix
BOTTOM LINE
Every vendor is NOT the same
Recommend starting incrementally
EMR changes the way physicians work
Does NOT reduce time in front of patients
Save time retrieving results, refilling medications, etc.
Start thinking “How can a afford NOT to have an EMR/EHR”
Health plans starting to pay more to practices with EMRsFor More Information
Mark R. Anderson, FHIMSS, CPHIMS
CEO and Healthcare Futurist AC Group, Inc.
118 Lyndsey Drive Montgomery, TX 77316
(281) 413-5572
eMail: mark.anderson @ acgroup.org
